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Single Breath-Hold T2-Weighted MR Imaging of the Liver

Value of Single-Shot Fast Spin-Echo and Multishot Spin-Echo Echoplanar Imaging

Masatoshi Hori1, Takamichi Murakami1, Tonsok Kim1, Masayuki Kanematsu2, Kyo Tsuda1, Satoru Takahashi1, Manabu Takamura1, Hiroaki Hoshi2 and Hironobu Nakamura1

1 Department of Radiology, Osaka University Medical School, 2-2, Yamadaoka, Suita-city, Osaka 565-0871, Japan
2 Department of Radiology, Gifu University School of Medicine, 40, Tsukasamachi, Gifu 500-8705, Japan.



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  		Fig. 1A. —66-year-old man with hemangioma. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5454/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2142/80) (D) MR images reveal lesion (arrow, A). Conspicuity of lesion is comparable among all images. Degree of image degradation caused by respiratory ghost, pulsatile blood flow ghost, and susceptibility artifacts is lowest in C. In D, note lack of image distortion due to susceptibility artifacts even at dome of liver.

 


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  		Fig. 1B. —66-year-old man with hemangioma. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5454/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2142/80) (D) MR images reveal lesion (arrow, A). Conspicuity of lesion is comparable among all images. Degree of image degradation caused by respiratory ghost, pulsatile blood flow ghost, and susceptibility artifacts is lowest in C. In D, note lack of image distortion due to susceptibility artifacts even at dome of liver.

 


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  		Fig. 1C. —66-year-old man with hemangioma. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5454/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2142/80) (D) MR images reveal lesion (arrow, A). Conspicuity of lesion is comparable among all images. Degree of image degradation caused by respiratory ghost, pulsatile blood flow ghost, and susceptibility artifacts is lowest in C. In D, note lack of image distortion due to susceptibility artifacts even at dome of liver.

 


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  		Fig. 1D. —66-year-old man with hemangioma. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5454/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2142/80) (D) MR images reveal lesion (arrow, A). Conspicuity of lesion is comparable among all images. Degree of image degradation caused by respiratory ghost, pulsatile blood flow ghost, and susceptibility artifacts is lowest in C. In D, note lack of image distortion due to susceptibility artifacts even at dome of liver.

 


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  		Fig. 2. —Graph shows composite receiver operating characteristic curves for solid lesions. Curves show observers' confidence in detection of solid lesions with conventional spin-echo ([UNK]) (Az = 0.89), respiratory-triggered fast spin-echo ({blacksquare}) (Az = 0.91), breath-hold single-shot fast spin-echo ({square}) (Az = 0.84), and breath-hold multishot spin-echo echoplanar ({circ}) (Az = 0.90) MR images. Note that no significant differences are seen among diagnostic accuracy of conventional spin-echo, respiratory-triggered fast spin-echo, and multishot spin-echo echoplanar imaging.

 


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  		Fig. 3. —Graph shows composite receiver operating characteristic curves for non-solid lesions. Curves show observers' confidence in detection of nonsolid lesions with conventional spin-echo ([UNK]) (Az = 0.91), respiratory-triggered fast spin-echo ({blacksquare}) (Az = 0.94), breath-hold single-shot fast spin-echo ({square}) (Az = 0.94), and breath-hold multishot spin-echo echoplanar ({circ}) (Az = 0.88) MR images. Note that respiratory-triggered fast spin-echo and breath-hold single-shot fast spin-echo images show best performance of four imaging techniques. Diagnostic accuracy for detection of non-solid lesions with multishot spin-echo echoplanar imaging is lower than with respiratory-triggered fast spin-echo and breath-hold single-shot fast spin-echo imaging.

 


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  		Fig. 4A. —67-year-old man with hepatocellular carcinoma. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5454/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2181/80) (D) MR images. Images A, B, and D reveal lesion 10 mm in diameter (arrow, A). Image C fails to show lesion.

 


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  		Fig. 4B. —67-year-old man with hepatocellular carcinoma. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5454/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2181/80) (D) MR images. Images A, B, and D reveal lesion 10 mm in diameter (arrow, A). Image C fails to show lesion.

 


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  		Fig. 4C. —67-year-old man with hepatocellular carcinoma. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5454/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2181/80) (D) MR images. Images A, B, and D reveal lesion 10 mm in diameter (arrow, A). Image C fails to show lesion.

 


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  		Fig. 4D. —67-year-old man with hepatocellular carcinoma. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5454/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2181/80) (D) MR images. Images A, B, and D reveal lesion 10 mm in diameter (arrow, A). Image C fails to show lesion.

 


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  		Fig. 5A. —64-year-old man with liver cysts. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5714/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2307/80) (D) MR images reveal cyst 35 mm in diameter (arrow, A). Another small cyst less than 5 mm in diameter is also seen (arrow, C). Conspicuity of small cyst is best in C of all four images. Image D, breath-hold multishot spin-echo echoplanar MR image, fails to show small cyst.

 


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  		Fig. 5B. —64-year-old man with liver cysts. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5714/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2307/80) (D) MR images reveal cyst 35 mm in diameter (arrow, A). Another small cyst less than 5 mm in diameter is also seen (arrow, C). Conspicuity of small cyst is best in C of all four images. Image D, breath-hold multishot spin-echo echoplanar MR image, fails to show small cyst.

 


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  		Fig. 5C. —64-year-old man with liver cysts. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5714/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2307/80) (D) MR images reveal cyst 35 mm in diameter (arrow, A). Another small cyst less than 5 mm in diameter is also seen (arrow, C). Conspicuity of small cyst is best in C of all four images. Image D, breath-hold multishot spin-echo echoplanar MR image, fails to show small cyst.

 


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  		Fig. 5D. —64-year-old man with liver cysts. Conventional spin-echo (TR/TE, 2000/80) (A), respiratory-triggered fast spin-echo (5714/75) (B), breath-hold single-shot fast spin-echo (infinite/95) (C), and breath-hold multishot spin-echo echoplanar (2307/80) (D) MR images reveal cyst 35 mm in diameter (arrow, A). Another small cyst less than 5 mm in diameter is also seen (arrow, C). Conspicuity of small cyst is best in C of all four images. Image D, breath-hold multishot spin-echo echoplanar MR image, fails to show small cyst.

 

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